Provider Demographics
NPI:1730393778
Name:HORN, AMY (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:HORN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 JEFFCO BLVD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-2713
Mailing Address - Country:US
Mailing Address - Phone:636-296-8123
Mailing Address - Fax:636-296-1226
Practice Address - Street 1:1761 JEFFCO BLVD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-2713
Practice Address - Country:US
Practice Address - Phone:636-296-8123
Practice Address - Fax:636-296-1226
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000155192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA2728001Medicare PIN